Richard H. Hughes, IV, Member of the Firm, William Walters, Law Clerk – Admission Pending, and Nija Chappel, Summer Associate (not admitted to the practice of law), in the Health Care & Life Sciences practice, co-authored an article in HealthAffairs, titled “Will the US Supreme Court Strike Down the ACA’s Preventive Services Coverage Requirement?”
Following is an excerpt:
The current Affordable Care Act (ACA) challenge in the Braidwood v. Becerra (formerly Kelly v. Becerra) case in the Northern District of Texas poses a threat to one of the law’s most popular features: its preventive services coverage requirement, Section 2713 of the Public Health Service Act (2713 or Section 2713). Section 2713, one of the law’s most substantive coverage guarantees, has strengthened the content of health insurance coverage to ensure that 167 million Americans have access to vaccines and cancer screenings, and other recommended preventive services, without out-of-pocket costs. According to the Urban Institute, Section 2713 provides 35.3 million children with well-child visits and recommended immunizations, 67.7 million adult women with well-woman visits and pre-natal screenings, PrEP and birth control services, and 64.5 million adult men with cancer screenings.
Section 2713 incorporates the preventive guidelines and recommendations (see exhibit 1) from federal advisory committees and agencies into federal insurance law, requiring private health plans and Medicaid expansion programs to provide for the coverage of recommended preventive interventions without patient cost sharing. In passing 2713, Congress deferred to these entities’ recommendations for purposes of determining coverage requirements. These committees and agencies include the US Preventive Services Task Force (USPSTF or Task Force), the Advisory Committee on Immunization Practices (ACIP), and the Health Resources and Services Administration (HRSA) (collectively, bodies).